| Abstract [eng] |
This study investigated the specificity and sensitivity of mpMRI/US-guided targeted prostate biopsy for the detection of clinically significant prostate cancer. Based on the results of this study, clinical practice could reduce the detection rate of clinically insignificant prostate cancer by completely abandoning systematic prostate biopsy and replacing it with adaptive MRI/US-guided prostate biopsy. This would allow a reduction in overdiagnosis and associated adverse outcomes and maintain the same frequency of detection of clinically significant prostate cancer. The study also allowed us to evaluate the possibility of improving the prognostic value of MRI by predicting the risk of cancer progression, selecting treatment tactics, or performing active surveillance. Our study showed that the level of DNA methylation of all investigated genes was statistically significantly higher in mpMRI-recorded foci than in perifocal samples, and that hypermethylation decreased significantly when it reached a distance > 10 mm from the tumor focus. Therefore, we can conclude that a safe distance from the tumor focus is at least 10 mm, and in clinical practice, focal hemiablation of the prostate would be considered as a radical treatment option for intermediate-risk prostate cancer. Noninvasive urine tests are very valuable for follow-up of patients after prostate cancer treatment, but larger prospective studies are needed. |
